Category Archives: Uncategorised

Case 126 – Update 3!

Thank you for everyone’s contributions so far! As advised by yourselves we have commenced our 57 year old gentleman who has newly diagnosed T-PLL on Alemtuzumab with the aim of consolidating with an allogenic stem cell transplant. He had been … Continue reading

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Case 126 – Update 2!

Thank you for everyone’s thoughts on the blood film. Think we’re all in agreement that blood film shows small to medium sized lymphocytes with high nuclear/cytoplasmic ratio and folded nucleoli. There are also occasional forms with nucleolus and cytoplasmic protrusions. … Continue reading

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Case 126 – Update 1!

  We advised the GP to repeat the asymptomatic 57 year old patient FBC (with film) in 4-6 weeks and to refer to haematology if absolute lymphocyte count was >10 or if he had associated cytopenias / B symptoms / … Continue reading

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Case 126 – The beginning!

You are the on-call haematology registrar who has been contacted by a conscientious GP regarding a fit and well 57 year old man who has an incidental finding of lymphocytosis. The FBC was performed as part of his monitoring for … Continue reading

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Case 125 – Summary

Thanks for all your input in managing this case or iron deficiency anaemia in pregnancy.   Case 45 previously discussed anaemia in pregnancy and this case highlights changes in recommendations for oral iron replacement as well as indications and complications … Continue reading

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Update 5

After 2 weeks the patient stopped taking the iron tablets as she was struggling with abdominal discomfort and constipation.  She is prescribed an IV iron infusion for later that week and attends for this but unfortunately she notices some discomfort … Continue reading

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Update 4

The patient did not attend any further appointment for follow up FBC or her 28 week appt.  At 36 weeks she finally attended her midwife appointment and her FBC was as follows: Hb 80g/L MCV 76fL MCH 22.7pg MCHC 31.2% … Continue reading

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Update 3

As most of you told us the film shows microcytic red cells with occasional pencil cells and target cells. Some of you mentioned variable haemoglobinisation, some macrocytic cells, occasional spherocytes and suggested we check folate and vitamin B12 levels and … Continue reading

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Case 125 – update 1

Our lady who is 8 weeks pregnant and feeling a little tired and sickly has a microcytic anaemia. You suggested that the most likely cause of the anaemia is iron deficiency but that we couldn’t rule out a haemoglobinopathy with … Continue reading

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Case 125 – the beginning

A 19 yr old lady attends the GP surgery for her booking appointment.  She thinks she is about 8 weeks pregnant. She feels a little nauseous and weary but has no significant past medical history and has not been taking … Continue reading

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Case 124 – Summary

Many thanks for all of your input this week. We covered the case of a 68 year old lady presenting with macrocytic anaemia and thrombocytosis. Key points in initial investigation: Exclude common causes – iron deficiency, B12/folate deficiency, myeloma screen, … Continue reading

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Case 124 – Update 2

Thank you for all of your input and suggestions. To summarise the case thus far: 68 year old lady referred with a macrocytic anaemia and thrombocytosis: Haemoglobin              87 g/L (115 – 165) White cell count          5.2 x 109/L … Continue reading

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Case 124 – Update 1

We are investigating a 68 year old lady referred with a macrocytic anaemia and thrombocytosis. Thanks for all of your helpful input thus far. Tests you have requested to date: Haemoglobin              87 g/L (115 – 165) White cell count … Continue reading

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Case 124 – The beginning

You are helping out in new patient haematology clinic. You have just had your post-lunch coffee and are raring to go! The next patient has been referred via the 2ww pathway by their GP for investigation of an abnormal FBC, … Continue reading

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case 123 summary

Our case this week looked at a 44 year old gentleman with a new diagnosis of AML. He presented with pancytopenia and blasts with auer rods on peripheral blood. Investigations confirmed a diagnosis of AML.  PML – RARA was negative, … Continue reading

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Case 123 update 2

The plan is to commence treatment with DA+myelotarg Cytogenetic and molecular studies show t(8:21) C-KIT positive FLT3 negative NPM1 negative Would this change your management? How are you going to monitor response in this patient?

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Case 123 update 1

 Our 44 year old male presented with the following full blood count Hb 62 WCC 35 plt 22 Blood film identified blasts, with auer rods. Blood film shows blasts cells, auer rods noted, thrombocytopenia and anaemia. Differential has included AML … Continue reading

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Case 123

44 year old man present to GP with fatigue, SOB and petechial rash. What investigations would you perform?  Level of urgency?? Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please … Continue reading

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Team Haem saves Christmas: The Summary

Jingle bells, jingle bells Jingle all the way Oh what fun it is to tweet TeamHaem’s case today!   The haemolysis is self-limiting No more parasites are seen The pitted red cells that have lost malaria Are being chomped up … Continue reading

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TeamHaem Saves Christmas Part 3

Jingle bells, jingle bells Jingle all the way Oh what fun it is to tweet TeamHaem’s case today!   Whilst sorting through the letters Poor Jingle remembers a bite A sneaky mosquito from an envelope Then that naughty insect took … Continue reading

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